On the 12th of May, the starting point of our discussion was burnout. It is important to note that this session happened in the context of the international university occupations and protests that reached Amsterdam to their full extent just around this time. So, health and well-being were indeed relevant topics. The discussion started with everyone answering the question ‘How would you define burnout?’.
The following thoughts came up (I am summarizing as best as I can):
Burnout is…
…the condition that precedes depression.
…the loss of interest, energy, creativity, passion.
…exhaustion.
…no longer caring about something.
…like impostor syndrome.
…extreme exhaustion.
…the realisation of lack of energy.
…disappointment.
…a disconnect between body and mind, a disconnection from the self. Like the mind wants to do something but the body is no longer able to.
…anxiety, restlessness, stress.
…losing your humanness, becoming a shell.
…the body resisting capitalism.
…”lefty fatigue”.
Burnout happens when we cross our own boundaries, when we are not aligned with our own feelings. Someone also answered with a new question: can you burn out of a job you did not like from the beginning?
From this exercise, it is very visible, that we have a lot of thoughts about how our health is affected by capitalism, but we barely have the language, the words to express these thoughts as even one word, burnout, means a million different things to different people. After we went around, I revealed the “official” definition of burnout: A person can burnout from a specific type of work, and its three defining symptoms are exhaustion, and cynicism as well as inefficacy regarding that specific type of work. So, my next question was ‘What do you think about the fact that there is a disease that has three defining symptoms, and one of them is inefficacy at work? How would you react if, for example, I would say that one of the defining symptoms of lung cancer is inefficacy at work?’
Many expressed that this sounds like some real capitalist bullshit, but others had more nuanced opinions as well. Indeed, this definition does sound like the real problem is not the lack of health of a person but their lack of exploitability. However, someone brought up that due to financial reasons, obviously, it is very important for them to be efficient at their job. So, when they become inefficient at work, that actually does mean that they are really struggling with something. This suggests, the separation of health and exploitation is not as simple as it might seem at first. When a person is healthy they are the least and the most exploitable at the same time. They are the most exploitable, because they are capable of producing the most in the long-term, but they are the least exploitable because they would not let themselves be exploited and, most likely, they have a healthy community around them that would protect them from it.
I also brought up another, more informal definition of burnout, which was “Exhaustion means going to the point where you can’t go any further; burnout means reaching that point and pushing yourself to keep going, whether for days or weeks or years.” But how can you go further when you cannot? With this, I just wanted to demonstrate how much of a buzzword burnout became over the past years. Because of this, I was also curious, to what extent people see burnout as a disease of the mind or of the body. Very quickly, we arrived to the issues with the mind-body dualism. This separation is attributed to Descartes (random white guy from the 17th century, so, according to my personal policy, we don’t need to know anything more about him). After claiming that humans are consisting of a mind and a body, very quickly, it was followed up by another claim: the mind is what makes humans really “human” (whatever that means), and the body is just not fully human. This claim has served as a very useful ideological tool for exploitation and oppression over the history of capitalism. Exploiting and oppressing classes often implied that the exploited and the oppressed are, for certain reasons, inherently “bodily” in nature, and so, they are not “fully human”, like them, who also have a mind, a soul.
This context serves as a warning, that we might overly psychologize or biologize health without noticing it. For example, the psychologization of women’s pain is a well-documented phenomenon with many different case studies. I brought a few of these to this session. The first was the case of hysteria, a 19th century disease which was considered as a typically “feminine” illness, mainly women were diagnosed with it. The interpretations of hysteria that I heard so far – mainly from the left – were that hysteric women actually had mental illnesses or rebelled against the Victorian era patriarchy, but the mean 19th century men labelled them as being hysteric, being crazy, basically. However, in a 2012 study, three doctors analysed the history of hysteria and arrived to the conclusion that in most cases, what was diagnosed as hysteria in the 19th century, was actually endometriosis. Endometriosis is a disease that occurs when the tissue found on the inside of the uterus, gets out of the place where it is supposed to stay and the immune system is not capable of destroying these tissues. This condition can cause pain that is so strong that patients sometimes faint from it. To this day, its psychologization continues, doctors often do not believe women’s pain. Its diagnosis is not very simple, but it is also delayed by cruelties like this. For example, in the US, on average, there are 11 years between the time of the first occurrence of the symptoms and the time of the diagnosis.
Another example I brought, was a Finnish study, conducted by the University of Helsinki. In 1999, the university put advertisements in newspapers in which they encouraged readers who suffered from back pain, to write about their experiences with the healthcare system. In 3 months, they received 165 stories, the study I read, analysed the stories of 30 women whose diagnosis was partly delayed by the psychologisation of their pain. They did not find such phenomenon among men’s stories. The length of these women’s stories ranged from 4 to 39 pages, the average was 12. Many women were told that they are imagining their pain, that their problems are psychological in nature:
“I had to believe that I was healthy! Even when my back was so painful, the painkillers enabled me to continue working.”
“I also began to believe that I imagined my pain. Even many doctors ‘‘helped’’ me in that belief.”
“And then the specialist said to me that the pain does not exist if you do not think about it. But when you think of it you feel it. That sounded so simple.”
“I went again to the specialist. Since he did not really want to listen to me I had written on a paper what I wanted to say. He thought I was fixated on my symptoms, that I stressed the importance of wellbeing and that I was disappointed when the physical exercise did not work. Of course I was disappointed when the physical exercises were not helpful. But I was most of all disappointed with not being taken seriously. And by the way, is there anybody who does not want to feel well?”
“[T]he doctor prescribed antidepressant medication, but I refused to take it because that was not the problem. I asked to have a magnetic scan, but nobody thought it was necessary so I had it done privately. The scan revealed a tumor and a worn disks in the lower back and between the shoulder blades. I went back to see the same doctor, even when I was not sure if he would take me seriously. I gave him my pictures and asked if antidepressant medication is helpful for these kinds of symptoms. Now I was sent to Helsinki for surgery…”
“The doctor did not find anything else than wear spots in my back. After an infection was cured he said that I am now all right, even when I could hardly walk. When my parents complained about it, the doctor said there is nothing wrong with my back, instead it is all in my head! In a smooth way and with a rising voice he suggested that I should be sent to another doctor, a psychiatrist.”
“My diagnosis was Spinal Canalis Stenosis and residual conditions after several slipped discs. Finally, I had a diagnosis. Even when it was awful, it was not “in my head”. I experienced a great happiness at this moment, even though it may sound strange.”
“I tried to forget it. I created several ways to forget it. I used a walkman that played a tape that there is nothing seriously wrong with my back, that I am not going to die from it, that I am not going to be paralyzed, that this is not the end of my life. I visited my neighbors, and all the friends that I had neglected for several years became my friends anew…I became very creative in developing new aids.”
What I also found interesting was that they did not describe painkillers in a positive light, only that it enabled them to work. However, even they were surprised by how happy they were when they finally received a proper diagnosis. I think this really shows that even the very definition of health is more complicated than we would initially think and that there is a lot of “noise” that affects and distorts our perceptions. I also mentioned that women and men experience slightly different symptoms when they have a heart attack and, partly because of that, women who are having a heart attack are often diagnosed with panic attack and given medications like Xanax. So, misdiagnosis and the psychologisation of health can have very directly harmful effects. At this point, we took a break. After that, we continued with another important aspect of the context of burnout: post-Fordism.
We started with a brief explanation of what post-Fordism is. After the Second World War, the dominant mode of the organisation of economic production was Fordist, meaning that workers were employed in large factories on permanent contracts mainly performing carefully determined physical labour that did not require much creativity. However, during the 1970s, a shift occurred in this mode of production and the new era is often referred to as post-Fordist. This means that nowadays, workers are more likely to be employed on fixed-term, project-based contracts, working several part-time jobs rather than one full-time one, and performing more emotional, intellectual, or creative labour on flexible hours. This is not a very strict separation, there were and are many different types of jobs in the economy, these are ideal types that rarely exist in their “pure” forms. But, at least for me, when I think about Fordism and post-Fordism, these are the “ideal” workers that naturally come to my mind based on what I read about these modes of production.
It is also important to highlight that this shift mainly occurred in the productive side of the economy, as formal reproductive jobs are more constant in time. For example, a “productive” worker could be screwing in the exact same screws all day long in the exact same types of cars in the Fordist era while they might be designing costumer-specific, unique products in the post-Fordist one. However, a cook or a nurse should feed or heal people the same way under post-Fordism as under Fordism. But, we could say that the education system also changed with the emergence of post-Fordism, even though teachers are mainly considered reproductive workers. Often, mainly on the West, at least in theory, teachers are no longer expected to “produce” students who know a lot of facts, poems or other things by heart and can calculate anything without a calculator, but “creative” students, who excel in adapting to the “quickly changing” labour market. So, the mode of production is never clear-cut in any economic system, but there are shifts in where the emphasis is in each one.
However, when talking about post-Fordism, I often felt like there was an implication that this is actually a mode of production that people would prefer to Fordism, but capitalism makes even this one exploiting. For example, I always heard the term self-exploitation associated with post-Fordism. By self-exploitation it is often meant that capitalism takes advantage of, or, to put simply, exploits the case when workers actually like the work they are doing or find it important, so they put in more effort and work for longer hours by their own choice. In the beginning of the session, many people included the loss of creativity or passion in their definition for burnout. Does this mean that the absence or presence of creativity or passion are some sort of “indicators of health”? So, would a “Fordist worker” be considered “ill” or “unhealthy” under post-Fordism? We discussed that some of us worked creative jobs, while others did not, some of us wanted to work creative jobs, while others did not. So, it seemed like it is not obvious what type of work is actually “healthy” or “unhealthy”.
At this point, I brought up an article I read about quiet quitting. In this article, employers defined quiet quitting as an “illness” of employees that happens when workers start to perform only the bare minimum, what their contract states, become very passive during brainstorming, and do not reply or even read emails after work. However, the workers who were quoted in the article, described quiet quitting as a “healthy” shift in their work. Doing only what their contract stated helped them set clearer boundaries, but, for example, they did not mention not being creative on purpose. So, employers and employees had clearly different definitions of what “healthy” work looked like, but these definitions were not the exact opposites of each other as they considered different factors as “indicators” of health. I thought that quiet quitting could be part of a “leftist definition of health”. However, someone expressed strong opinions that quiet quitting is actually not “healthy” as it means fully giving up on finding a job that you at least do not see as pointless. And, of course, the problem of individualisation arises. If everyone is quiet quitting, does that mean that no one will join the union or a strike? To that, someone else replied that a work-to-rule, or Italian strike is basically collective quiet quitting, as it means the disruption of a firm by employers who do word-by-word what their contract states which slows down production until it’s no longer profitable enough.
Finally, I also asked what would people think of a work-based society as a goal for the left for “healthy” work? By work-based society, I mean that a society, which is based on work for each other and not on, for example, common consumption choices, and where work is actually the base of society, what creates and maintains society, and not the base of, for example, profit-making. This would mean the elimination of alienation, as all work that is done, should be considered useful by all members. And, if the goal of work is to reproduce society, then could we say that the goal is to do less productive work and aim to only perform reproductive labour? Could one goal of the left be a society where life is reproduced for itself and not for any other purpose?
This resulted in another long discussion in which it turned out that we actually don’t really know what separates productive and reproductive labour from each other. For example, does a farmer, producing vegetables directly for human consumption, perform productive labour because their labour has products, vegetables? Or reproductive labour, as they are directly contributing to the reproduction of the labour force? Concerns were also raised that only performing reproductive labour sounds like we only aim to keep a boat afloat but never reaching a harbour. As a final point, I mentioned that many former addicts refer to themselves as “recovering addicts” even when they have been clean for several years. and at first, I also found that strange, it sounded like they are indeed just keeping a boat afloat, not falling back into addiction, but holding their life on pause. However, by now, I think that the term “recovering addict” means the commitment of a former addict to their own health and healing for life. Maybe reproductive work is actually also productive? We did not answer these questions, however, we arrived on common ground in the conclusion that “from each according to their ability, to each according to their needs”.